Acebutolol Hydrochloride

What it is used for

According to the FDA label, acebutolol is used to manage high blood pressure (hypertension) in adults, either alone or with other medicines, especially thiazide diuretics. It is also used to manage ventricular premature beats (a type of irregular heartbeat).

How it is taken

The FDA label states that for high blood pressure, the usual starting dose is 400 mg once daily, but some patients may need twice-daily dosing. The typical maintenance dose is 400 mg to 800 mg per day, with some patients taking as little as 200 mg or up to 1200 mg daily. For irregular heartbeat, the usual starting dose is 400 mg daily given as 200 mg twice a day, gradually increased to 600 mg to 1200 mg per day. Older patients may need lower doses, and doses above 800 mg per day should be avoided in the elderly. If stopping treatment, the dose should be reduced gradually over about two weeks.

Warnings

• The FDA label warns that acebutolol can cause or worsen heart failure in patients with heart problems. At the first signs of heart failure, patients should be treated with digitalis and/or diuretics, and if heart failure continues, acebutolol should be stopped.
• Abruptly stopping acebutolol can cause worsening of chest pain (angina) and, in some cases, heart attack or death, especially in patients with coronary artery disease. The dose should be reduced gradually over about two weeks.
• Acebutolol can reduce blood flow and worsen symptoms in patients with peripheral or mesenteric vascular disease.
• Patients with bronchospastic disease (like asthma) should generally not take beta-blockers. However, low doses of acebutolol may be used with caution in those who cannot take other treatments.
• Beta-blockers like acebutolol can mask the fast heartbeat that signals low blood sugar (hypoglycemia) in diabetic patients.

Common side effects

• Fatigue (11%)
• Dizziness (6%)
• Headache (6%)
• Constipation (4%)
• Diarrhea (4%)
• Dyspepsia (4%)
• Nausea (4%)
• Flatulence (3%)
• Insomnia (3%)
• Abnormal dreams (2%)
• Chest pain (2%)
• Edema (2%)
• Depression (2%)
• Rash (2%)
• Frequent urination (3%)
• Cough (1%)
• Dyspnea (4%)
• Rhinitis (2%)
• Abnormal vision (2%)

Interactions

The FDA label states that acebutolol may have additive effects with catecholamine-depleting drugs (like reserpine), leading to marked bradycardia or hypotension. Exaggerated hypertensive responses have been reported with combined use of beta-blockers and alpha-adrenergic stimulants (found in some cold remedies and nasal drops). Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the antihypertensive effect of beta-blockers. No significant interactions were observed with digoxin, hydrochlorothiazide, hydralazine, sulfinpyrazone, oral contraceptives, tolbutamide, or warfarin. However, both digitalis glycosides and beta-blockers slow heart conduction and can increase the risk of bradycardia when used together.